FeaturedApplying for Medical Assistance

 Help Sheet for Applying for Medical Assistance

January 2017

Please note that I am writing this to you as a guide to assist you. I have had many family members voice frustration with me as to the “how’s” of navigating through the medical assistance application process. I am not an attorney, and this is not legal advice but rather things I have learned over the past 25 years of helping families through the process.

We accept the GRH, Group Residential Housing rent rate which the State of MN determines every summer, for a shared companion room. This means that you can only remain in a private room while on medical assistance, if someone other than the person applying for medical assistance chooses to pay the private room differential for the resident.

  1. When should you apply for Medical Assistance, which is generally titled elderly waiver (EW) in assisted living settings?
    1. A good rule of thumb is to call the county phone numbers in the county which you reside 60 days before your assets reach $3,000 as a total balance.
    2. If you do not have care needs as determined by the state, you may be denied access to assisted living, if your needs could be met in another independent setting. The nurse who determines your level of care needs determines this on the LTCC Consultation or MN Choice Assessment. The State of MN wants to make sure seniors are placed in settings which meets their needs.
    3. You can access the medical assistance application through this link: https://edocs.dhs.state.mn.us/lfserver/Public/DHS-5223-ENG. 
  1. There are two very important steps to make: (1) is to apply for financial assistance and fill out the medical assistance application and call the county financial worker (2) is to call for a LTCC or MN Choice level of care assessment with the county.
    1. The financial eligibility is one aspect of the process, which determines financial need after the county reviews the application completed by the resident/family member. Once the financial edibility is started with the case has to be opened in 60 days, otherwise if paperwork is not completed, the case will go back to day zero and the process for opening medical assistance may be delayed and the resident may have no payer source to pay their bills for care in a setting such as assisted living.
    2. The level of care assessment is something that is a second aspect of the process, and this is done by a separate agency in the county. This level of care assessment determines medical need and is called a LTCC assessment of MN Choice assessment. Once the nurses from the county do the level of care assessment, this is good for only 60 days. This means that the financial team must have all the paperwork they need timely to assure the case is opened for the senior applying for medical assistance.
    3. Once the financial team opens the case, and the nurse determines level of care need to support assisted living need, then the provider can bill the State of MN for the service portion of the cares. It is important to know that the state does not allow back billing, therefore the resident is considered private pay until the county opens the medical assistance case.
    4. Important phone numbers to call for the county you reside in: 
  1. For Diamond Willow Residents who reside in Lester Park, Proctor, Mountain Iron and Keystone Bluffs Residents they should call 218-733-2725 to apply for financial assistance. Please call 218-726-2366 for a LTCC/MN Choice level of care assessment.
  2.  For Diamond Willow Residents who reside in Little Falls, they should call Morrison County at 320-631-3577 and ask for the long term team to assist them with the financial application. Then they should call 320-632-6664 which is public health for the MN Choice application.
  3.  For Diamond Willow residents who reside in Alexandria, they should call Douglas County at 320-762-2302, and this is the number to call to apply for medical assistance. Then call 320-763-6018 and this is public health nurse line to request a level of care assessment which is known as a LTCC consultation or MN Choices.
  4.  For Diamond Willow residents who reside in Detroit Lakes, they should call Becker County at 218-847-5628, and press zero and ask for: The adult service intake team who processes the LTCC Long Term Care Consultation which is known as the MN Choices and this determines level of care need. Then you will need to call back the same number at 218-847-5628, and press zero and ask for the financial team to apply for medical assistance in assisted living.
  5. For Diamond Willow residents in Baxter, they should call Crow Wing County at 218-824-1250, and when they answer it will say Crow Wing County Economic Assistance line. Then there will be a menu of seven choices. Press, number 0 to speak to a county representative. Then it will say to list to four more choices, then press 4 to speak to a county representative. Please let them know you need to apply for medical assistance and you reside in assisted living. Then call 218-824-1140 to schedule a LTCC screen/MN choice assessment which determines the level of care need.
  6. For Diamond Willow residents in Grand Rapids, they should call Itasca County at 218-327-6706 or 218-327-6146 and let them know you need to apply for financial assistance and you reside in assisted living. You also need to let them know you need a LTCC/MN Choice screen from a nurse to determine the level of care need of the person who is applying. 
  7. For Diamond Willow residents in Park Rapids, they should call Hubbard County at 218-732-2453 and let them know you need to apply for financial assistance and you reside in assisted living. You also need to let them know you need a LTCC/MN Choice screen from a nurse to determine the level of care need of the person who is applying.
  1. Other things to be aware of:
    1. It is important to know that your monthly income is a completely separate thing from your total assets when applying for medical assistance. Therefore, assets can be a variety of items such as savings, checking, stocks, bonds, commercial or residential property, land etc. as just a list of some common examples.
    2. If you are a married couple, the county will do an assessment to determine your eligibility and sometimes one person remains in their home and one person needs a higher level of care. Sometimes both people need a higher level of care and the county has a formula for this which the state has set forth.
    3. The look back period is 60 months before the date of applying for medical assistance (elderly waiver), therefore if assets are transferred outside of this time period there may be a disqualification period to match the amount of money transferred. This is something the county would determine when doing the application for medical assistance.
    4. Have you had a Long term Care Consultation? This is what is also referred to as MN choices which determine that the applicant has care needs which the assisted living provider offers.
    5. If the county determines you have a high monthly income as defined by the State of Minnesota, you may have what is called a “Spenddown or waiver obligation”. What this really means is that in addition to the amount you pay for your rent, which is currently $891 per month for a shared room when on medical assistance, then you are personally responsible to pay an additional amount of money from your monthly income to the provider monthly. This is what “spenddown or waiver obligation means”. If you have a spenddown or waiver obligation, the state reduces the amount they pay the provider for the services, because the resident has a high monthly income and can afford to pay a higher portion.
    6. During the time you are applying for medical assistance, the resident is responsible to continue paying the provider monthly to avoid an eviction notice. All residents are considered private pay until they are opened on medical assistance.

 4. Some items to gather early for records the state will want to review

  1. Recent bank statements of balances
  2. Real estate property tax statements, and documents showing amount owed against property
  3. Burial contracts and the name of the company or funeral home that holds the contract
  4. Other assets such as bonds, trust, stock ownership, annuities, etc. and you must have the current statement with any balance owing against asset.
  5. Other

Is Assisted Living the Right Choice for Your Senior Loved One?

If your loved one can no longer live alone without risk to his/her health or safety, it is time you help them get the care they deserve. Assisted living facilities specialize in providing professional assistance to senior citizens while allowing them some level of independence. But is the right choice for your loved one?

When weighing the pros and cons of sending a senior family member to a facility, ask yourself the following questions that will help determine whether you are making the right choice or not.

  • Is your loved one fine on their own? Living alone in a home is not only expensive but its maintenance calls for extra effort. Raking leaves in the fall, shoveling snow in the winter, keeping an eye on the housekeeper and carrying out daily chores may too much of work. If your loved one is not in a position to handle all the work alone (even with the help of a caretaker), assisted living might just be the right choice.
  • Are you fine with taking care of them? Especially if you have a family of your own, giving constant attention and care to an old family member can become expensive and difficult after some time. If you find yourself struggling to look after them, it is best to leave them in the care of professionals.
  • Is your loved active and interactive? A passively inactive senior loved one is more likely to feel bored, anxious and depressed. So, unless they are involved in social gatherings and interactions frequently, sending them to an assisted living facility will be a better way to go. This is because these care centers make sure residents get plenty of physical and mental exercise through various classes, activities and organized group fieldtrips.

Answering these questions will help you determine if assisted living is the right choice for your senior loved one or not.

Importance of Avoiding Crisis-Based Decisions Regarding Assisted Living

Whether it is a fall, death of a spouse, or loss of a reliable caregiver, many families find themselves making assisted living decisions in “crisis mode”. Although this decision can prove life changing for some, others may simply come to regret it in the end. To save yourself the added stress and hassle, here are a couple of ways in which you can avoid crisis-based assisted living decisions:

Discuss with Family Members in Advance

A family who takes action only when faced with crisis usually finds itself making decisions it will soon come to regret. So, it is better that you handle matters farsightedly and encourage family members to voice their wishes and concerns, along with important legal, financial and medical records, beforehand. For a decision to be beneficial, it is important that all family members should be involved in it equally.

Start Asking for Recommendations

Ask your friends, neighbors and physicians for recommendations. Browse the internet, schedule appointments and visit assisted living facilities personally. Take along your family members too so everyone can have a say in the matter.

The Importance of Avoiding Crisis-Based Decisions

Making decisions, especially those that affect your health and safety, require sufficient time for thorough research and the decision-making process itself. Most crises leave you mentally scarred, and therefore you may not be able to choose as wisely as you can otherwise. Furthermore, there is a chance that you may be exploited by a facility if it detects urgency in the situation, resulting in you either paying more or settling for something mediocre.

It is therefore important that you either decide such critical matters in advance or wait till the crisis is under control. This way, you will be more likely to make a decision that will benefit you in the long run and therefore, be able to get the best care for your senior loved one.

How to Compare Assisted Living Facilities

If your senior loved one is facing trouble with their daily tasks, like dressing, showering, running errands and getting around the house, the answer may lie in an assisted living facility. These facilities provide their members with all the daily needed support as well as independence so that an optimum level of contentedness can be maintained. Leaving your home, the memories and the people behind can be difficult, but when you make a decision that precisely addresses the needs and concerns of you or your senior loved one, you are ultimately making sure that the years spent ahead are happy.

When considering a shift to an assisted living facility, a thorough comparison between different facilities is important that will help you make the right decision. Nevertheless, this part is overwhelming and time-consuming, especially if you do not know where to start. Following are the three key areas that you need to take into account when comparing assisted living facilities:

Cost

It is important to note that that different facilities have different pricing structures, which can vary from a daily to a monthly rate. Furthermore, the features included in the pricing may also vary from one facility to another. It is therefore extremely important to have a thorough understanding of what is and isn’t included in the basic price since many assisted living facilities offer different levels of care or tiered pricing.

Licensure

Depending on the needs of your senior loved one, you will need to determine the type of license that will be best suited to meet your needs. Examples of licensure include Extended Congregate Care and Limited Nursing services.

Lifestyle Amenities

Staying active and healthy is extremely important, and therefore you need to ensure whether the facility of your interest is offering recreational programs, such as educational classes, field trips, fitness sessions, sports, arts and crafts.

Keeping these three points in mind will help you decide whether a facility is right for you or not.

Why You Should Consult an Assisted Living Advisor

Watching our loved ones get old is difficult. You know that they are no longer able to live on their own, yet you don’t want their happiness sacrificed or their independence lost. Instead of living in denial, be aware. Although navigating assisted living facilities can be a frustrating and emotional, there are a number of resources you can find information from. On top of that, you also have assisted living advisors who can make the entire process much easier and in precise accordance with your needs.

Why Consult an Assisted Living Advisor

Listed below are 4 reasons why you should involve a professional when making this major decision:

1.     You Are Emotionally Frustrated

Deciding to send off your loved one in the care of a third party is never an easy decision. It is no surprise that people tend to not make their best decisions when overwhelmed or under emotional stress, and that is why you need someone professional to do it for you (or at least help you decide better).

2.     Advisors Know All the Local Facilities

Most assisted living advisors focus on a specific area and are therefore more aware of the ins and outs of the locality. They visit communities on a regular basis and have been working with numerous families with a similar situation as yours, and so can be a great source of information and guidance.

3.     Save Time

Instead of going through a big list of facilities yourself, an advisor can provide you with a detailed list of appropriate options, and can explain you the benefits and special features of each community.

4.     Personalized Assistance

You can tell the advisor exactly what you are looking for and they will create for you a list of communities solely based on your criteria. They will also guide you throughout the process and keep in touch.

So, as you can see, consulting an assisted living advisor can offer a number of benefits and help you make the best possible decision!

How Much Does Assisted Living Cost?

Cost is perhaps the determining factor when planning a shift to senior living care for a loved one. Fortunately, assisted living, just like the diversity in styles, settings, and amenities, comes with a variety of price points.

To begin with, costs differ in terms of residence, types of services required and apartment size. The primary charge may cover the whole package, or there may be extra charges for special services, like physical therapy.  Shared suites is a common way of cutting down on costs since the total charge is split between members. A majority of facilities charge on a monthly basis, but some ask for long-term arrangements.

Basic rates may vary depending on the size of the residence, for instance studio, one, two or three-bedroom unit. Keep in mind that basic rates usually cover only room, and two to three meals. Extra cost may include a month’s rent, entrance fees, deposits, and charges for other services like laundry and housekeeping.

On average, solo accommodation in a room costs $3500 per month, which means a total of $42,000 per year, as researched by various nonprofit senior care organizations including Genworth Financial Inc.’s Cost of Care Survey released in April of 2014. As compared to a nursing home care or home health, assisted living can prove much cheaper in the same geographical locality.

More than 50% of assisted living facilities use a tiered pricing model that offers bundled services, research suggests. For example, a resident requiring minimal assistance would be ranked at the lowest level. Other models include fee-for-service, la carte or all-inclusive basis. Providers typically appraise care plans and service to make sure residents’ needs and requirements are being properly met. Bills are usually paid on a monthly basis.

That being said, you should weigh the cost of assisted living against the comfort and convenience your senior loved one will receive as compared to living at home.

Assisted Living Trends for 2017

The winds of change will be seen blowing through assisted living facilities worldwide. As baby boomers reach retirement age, the landscape of senior assistance and care will change inevitably. Looking at the approaching months of 2017, listed below are some of the anticipated living trends in assisted living:

Residents Will Go High-Tech

Every year, baby boomers take more steps towards embracing technology to improve their living standards and quality of life. In 2017, more companies will invest in wearable tech for seniors, such as remote controls for lights, windows, doors and thermostats or senior-friendly cell phones that have larger displays and louder sound for those residents who suffer from impaired hearing or poor vision.

Other examples include geo-fencing, a compact, unobtrusive device with GPS technology which is worn by patients of dementia or Alzheimer’s and alerts the caregivers when the patient wanders past a pre-set range, and advanced PERS which consists of features like fall detection.

Assisted Living Facilities Will Go Green

With the rising cost concerns, which prevail in the senior care industry, assisted living facilities are realizing the growing importance of going green. In 2017, these care centers are more likely to adopt eco-friendly measures, some of which include:

  • Meeting energy standards of EPA
  • Taking steps towards better air quality indoors
  • Improving weatherization of buildings

More Person-Centric Advantages Will Be Offered

This year will bring increased social interaction among assisted living residents through various person-centric activities that will help them grow as people. Enjoyable and healthy social activities such as tai chi, yoga, game nights, exercise classes, book clubs, barbecues, and organized field trips to museums, restaurants and theatres are likely to continue in order to help the members stay active and happy.

These are some trends that you can expect to see in assisted living in the current year.

Why Seniors Should Stay Active at Assisted Living Facilities

Assisted living facilities are designed to assist senior members stay physically, mentally, and socially active in order to maintain a healthy, independent and active lifestyle besides receiving the help and care that they need.

Staying active, especially for seniors living at assisted facilities, is important because it offers a wide range of benefits, from improving social relationships to strengthening memory and preventing anxiety and depression.

For a majority of seniors, staying active means deeper bonding, making new friends and connecting with fellow seniors on a completely new level. An aerobics class at an assisted living facility will provide a chance to catch up on the latest news, make friends and stay engaged and motivated. Staying active, whether in an intense physical exercise regimen or a nice lawn mowing routine has the ability to uplift the mood disposition, making seniors view things in a more positive light.

Because staying active enhances mental capacity, the general mental health of seniors will improve by staying active. Physical activity is critical for everyone, especially for seniors who are concerned with healthy aging. Assisted living provides members with various health improvement programs, such as those that improve balance and posture to reduce risks of falling.

Staying active is also crucial for seniors because it helps with healing. In general, the healing process takes longer with increasing age. However, with staying active, your wounds heal 25% faster as compared to when your body doesn’t partake in regular activity.

In conclusion, staying active for seniors in assisted living facilities helps improve all facets of their lives, including physical strength, cognitive functioning, and social interaction. It helps prevent major emotional and physical problems, like memory decline, anxiety and depression, and also encourages them to make the most out of their senior years, with fewer physical and mental complaints.

The Importance of Visiting Seniors in Nursing Homes During the Holiday Season

Visiting seniors in nursing homes during the holiday season is not only rewarding, but offers the residents’ innumerable health benefits, both physical and emotional. As per studies conducted by the Journal of Health and Social Behavior, social seclusion has a direct relation with depression, increased rates of morality and infections, and health and cognitive decline, which seniors are at risk of.

Therefore, maintaining verbal and personal communication with our loved ones in care houses can help ward off these detrimental effects. Following are three reasons highlighting the importance of visiting your senior loved ones in nursing homes during the holiday season:

Helps You Evaluate Their Safety, Health and Well-Being

Possibly the most important reason why you should visit seniors, not only in the holiday season but in general is to check up on their health and happiness, and ensure there nothing of concern. If you have too much on your plate already and may not get the time to visit them throughout the year, the holiday season is surely a good opportunity.

Revive and Create Positive Memories

The holiday season is a time of joy, which you can spend with your old dear ones and reminisce about all the pleasant memories spent together. You can also bring them homemade stuff, presents and letters, which will help them hold on to new memories for the rest of the year. An entire family getting together to celebrate the holiday spirit will be remembered for life, and help your senior loved ones feel loved and appreciated.

Help Them Stay Emotionally Engaged

A personal visit from family members goes a long way in ensuring positive emotional health of seniors, especially if the senior member lives alone or is rather isolative with other residents.

As you can see, your senior loved one will benefit tremendously by spending a few minutes with you during this festive time. Make sure you pay them a visit in next few weeks!

The Risks of Loneliness for Seniors and How Assisted Living Can Help

As per the findings of “A Review of Social Isolation”, the prevalence of loneliness among seniors who reside at home than in senior care facilities may be as high as 43%. Social isolation and loneliness are both associated with an increased risk of mortality due to the absence of communication that would otherwise take prompt action in case of any acute symptoms.

Furthermore, a lonely and socially inactive senior is more likely to suffer cognitive decline, and have both poor physical and emotional health, as concluded by a study in 2009 utilizing information from the Health, National Social Life, and Aging Project. More often than not, loneliness translates into long-term health problems like arthritis, lung disease, depression and impaired mobility.

Senior care facilities like assisted living and nursing homes help combat this issue of loneliness and social withdrawal by offering various opportunities for socialization with peers, not only through shared residence but other planned and structured activities, like field trips and cultural events. Assisted living really inspires seniors to participate and get involved in social affairs, events and daily activities, which pave the way to a greater quality of life and more happiness.

Most assisted living facilities also offer lifelong learning lessons like computer training, art classes and book clubs. Others arrange guest lectures by professionals and scholars, and allow members to take advantage of nearby campus resources, like the local library, gym and cultural events. All these facilities expose older adults to the outside world. They also get the chance to make new friends and learn from others’ experiences.

Besides offering seniors the chance to intermingle, assisted living also promises its share of independence by allowing residents to carry out activities that make them happy, which in turns ensures better quality of life. Therefore, any senior battling the risk of loneliness should opt for assisted living.